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E V E R E T T PUBLIC WORKS REVIEW WORKSH <br /> WASHINGTON EET <br /> PROJECT ADDRESS: 9502 18TH AVE W UNIT J Permit#: B2310-050 <br /> DESCRIPTION OF WORK: NEW SFR-REF RB2306-005—UNIT J <br /> PW Reviewer to select all that apply below: <br /> ility Permits (Note:Permit Technicians to Create Utility Per it for Sewer, ater,Fire,and Irrigation,as selected below) <br /> SANITARY SEWER: DOMESTIC WATER SERVICE:(Attach Calculation&Cos st.) <br /> ® New Connection to main plus 1 connections to building ❑ New Connection,Size - ❑Per Cost Estimate <br /> ❑ Alteration ® Meter Only,Size 3/4-inch-❑Per Cost Estimate <br /> ❑ Repair �i pO <br /> ® Water System Development Fee Total:$ 1.00 g�T' <br /> ❑ Cap-off,quantity <br /> ® Sewer System Development Fee Total:$5 5 00 2 g,d <br /> ❑ Reconnection to stub ❑ Water Service Line(behind meter),Size <br /> ❑ Backwater Valve ❑ Backflow Prevention(Outside Building):❑RPBA ❑ CVA <br /> NOT REQUIRED r 1 BOO ❑ NOT REQUIRED ' e 7 <br /> Explanation/Utility Permit#V_ Explanation/Utility Permit# "t q02 d 3 <br /> IRRIGATION SERVICE:(Not Including Cost Estimates) FIRE SERVICE:(Attach Cost Estimate/Request for Reference) <br /> ❑ New Connection,Size ❑ New Connection,Size -❑Per Cost Estimate <br /> ❑ Meter Only,Size ❑ %"Detec eter Only,Service Size <br /> ❑ Water Sys Development Fee Total:$ ❑ Back Prevention(Outside Building):❑DCDA <br /> ❑ Backfl Prevention(Outside Building):❑DCVA ® 4eREQUIRED <br /> ® Npla REQUIRED Explanation/Utility Permit# <br /> nation/Utility Permit# <br /> WATER DEPARTMENT COST ESTIMATE NEEDED-(If yes,PW Reviewer to send cost estimate request to Water Department) <br /> ❑ Yes, tity .See attached for reference. <br /> ® N REQUIRED <br /> Plumbing Permits(Note:Permit Technicians to add all items selected below to Plumbing Permit for items inside building only) <br /> Backflow P vention(Inside Building): ❑DCVA(for Domestic service) ❑RPBA(for Domestic service) ❑DCDA(for Fire servic <br /> ® NO EQUIRED <br /> Building Permits(Note:Permit Technicians to add all items selected below to associated Building ermit) <br /> STORMWATER SYSTEM DEVELOPMENT FEES: TRAFFIC MITIGATION FEES: <br /> ❑ YES,❑See Attached for calculations/credit ® YES,Traffic Mitigation Total:$4 .00 <br /> To be added on PW To ed on ❑See Attached for calcu ions/credit <br /> Quantity charged SF Quantity charged SF ❑ NOT REQUIRED <br /> $TY is❑Ground only aces QTY is❑Roof only❑all surfaces S5a2 ,O v <br /> ® NOT D Reviewed under PW2211 021 _ <br /> Additional Checklists: <br /> ADDRESS LETTER REQUIRED? (If yes(new assigned address),print out Address Letter from TRAKiT Print Menu and include) <br /> ® YES—TYPE:®SFR []DUPLEX ❑ADU ❑INFILL DWELLING ❑MULTI-FAMILY []COMMERCIAL <br /> ®See Attached Letter,2 copies(Permit Techs to issue one copy to applicant with permits,scan one copy to Jeffrey Marks) <br /> ®Digital copy attached to permit record,Permit#132310-050 <br /> ®Saved to Address Folder in Development Tech File <br /> ❑ NOT REQUIRED <br /> FIRE SPRINKLERS REQUIRED? <br /> ❑ YES—Type <br /> ® NOT REQUIRED <br /> Reason: <br /> PUBLIC WORKS PERMIT REQUIRED? <br /> ❑ YES,Permit#PW <br /> ❑Stormwater NPDES Tab Completed in TRAKiT ❑ADA Tab Completed in TRAKiT []Inspections Added in TRAKiT <br /> ® NOT REQUIRED <br /> Worksheet Completed By: 7eite Date:1011319093 <br /> Worksheet Reviewed By: 7/tad lk4oQst Date:10/13/2023 <br />